Sunday, 1 November 2015

Pharma Excesses

ProfG has been telling us how much pharma contributes to Society and the Economics of the society, how else would those professional paper writers and poster makers have jobs:-). Therefore we should not rock the boat and let pharma do what it does best.....make loads of money.However, whilst we should all agree that pharma have a useful roll to play in Society there is an uneasy feeling it is it not simply making money, it is making alot of money and our health is being fleeced by greedy CEO's and Shareholders. Yes companies should recoup their R & D costs and more as it is a risky business but the price of drugs have nothing to do with this. It is simply how much you can pay.If you dog takes a drug it costs this much if the same drug is used in cancer it costs that much, in arthritis this and above all multiple sclerosis....Ker-chingWe all know that America pays more for drugs than the rest of the World and for this pleasure they get Pharma companies creating jobs and locating into the States whilst leaving Europe in droves. However, you can only gouge so much cash and US polititicans are waking up to pharma excesses.

It is argued the Taxpayer pays twice"The taxpayer not only shells out at the pharmacy but often plays a critical role in funding these drugs in the first place. In other words, the public pays twice."Big Pharma, while of course contributing to innovation, has increasingly decommitted itself from the high-risk side of research and development, often letting small biotech companies, universities and the NIH do most of the hard work. Indeed, roughly 75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding, while companies spend more on "me too" drugs (slight variations of existing ones.)"It is well known that Big Pharma spends more on marketing than on R&D. It also spends on making its shareholders rich. Pharmaceutical companies, which have become increasingly "financialized," distribute profits to shareholders through dividends and share buybacks designed to boost stock prices and executive pay"."Rather than making patient, long-term investments, large shareholders in Big Pharma companies are looking for a quick, easy, guaranteed return"."As evidence that Big Pharma is spending less on research becomes irrefutable, the pharmaceutical industry has used other excuses to support high prices. It has, for instance, argued that prices are proportionate to the intrinsic value of the drugs".

"The supposed partnership between public and private sectors is increasingly parasitic, hurting innovation and fueling inequality through reduced investment, exorbitant prices for consumers and more money siphoned off for shareholders.""In exchange for the massive public investment, Big Pharma should be asked to reinvest profits back into R&D rather than giving such a high percentage to shareholders"."Given that most drugs originated thanks to public funds, the prices of these drugs should.......reflect the taxpayers' contribution".

Pharma will Say....Bugger off as it buys a few more politicians favours with positions on the board and there is no change to Status Quo:-(. The State used to pay for under-graduate education in the UK and then Pharma would take them into its workforce.Maybe a shock wave could occur if the public got repurposing onto the agenda and George Osborne will take another beating (This week The House of Lords rebelled against tradition and defeated a Government bill on Tax credits)......will it happen? I suspect the fireworks this week will on the 5 November for Bonfire (Guy Fawkes) Night.Come the 6th of Novemeber I suspect we should be throwing some of our politicians onto one.

However can we get a shock.Here is what one of our posters commented onMy MP replied to my email, "As many of the Westminster SNP Group as possible will aim to attend and vote in support of this Private Members Bill and we hope that the UK Government will then take it forward. ".

So lets hope Braveheart comes to London. Hopefully history won't repeat itself, as can be read on a plaque on the wall of Barts Hospital which showed what happened when Wiliam Wallace Came to London in 1305.

I heard second-hand earlier this week that a UK neurologist had taken a stand on high-cost drugs and had decided not to prescribe alemtuzumab to his/her patients with MS; Lemtrada was too expensive. He/She was still angry about the hike in price of Lemtrada, compared to Campath. In essence this neurologist has vetoed NICE. If this story is true it raises many issues around prescribing in the NHS. If I get time this week I will post something more on the issues raised by this.

MD you are not quoting Prof G correctly; his post on high cost drugs was much more nuanced and far less reactionary than yours. If it wasn't for pharma would we have the current smorgasbord of treatment options?

By the way I think people with MS would be a lot worse off under the SNP. The SNP have their heads in the clouds.

If you read the link you can see where the quotes come from they are not necessarily mine however it is opinion. They were published in the LA times.

As you are well aware ProfG has alot of pharma dealings and I know that he had this very discussion with a senior pharma bod.

Maybe he swallowed and regurgitated the mushroom food being spun.

Likewise maybe he is taking a stance to get a churn of comments and a reaction

In addition because he sees both sides he can make more informed choices and as you know I shoot from the hip/heart.

As for politics North of the border it is irrelevant to the point I am making it that we should support the repurposing bill and get it properly debated.

If there was a Yorkshire Nationalist party with the power to influence this I would suggest they vote too, likewise the Tories should and the labour should too.However I know the Government stance and the Tories will fall in line I suspect.

Perhaps I should have appealed to the Lib Dems to support this too as there are a few of them and they could make a splash.

However, after their last show in Government who would believe them if they say that are going to do one thing.....tell that to the students :-).

Just trying to play Devil's advocate. The issue of high-cost drugs is very very complex.

Unfortunately, the parallels between Big Pharma and the Big Banks make the issue a hot potato. Governments across the world decided that some banks were too big to fail and that they are associated with a systemic risk to society and the world economy. Therefore they were bailed out and regulated more heavily. Similarly with Big Pharma we don't at present have an alternative with regard to drug development. What is needed is more regulation. For example, the Sunday Times is running an article today on "2,000% drug price rise ‘milks’ NHS"; there should be legislation in place to prevent this. It has always been my understanding that Society has a deal with Pharma; we give their innovations patent protection for a finite period during which time they are able to recoup their development costs and make a profit to feed their R&D pipeline and to pay their shareholders. Once the patent comes to and end prices are expected to drop. The examples below indicate that Pharma Excesses need to be curbed.

Excerpts:

PHARMACEUTICAL companies are “milking” the NHS by increasing the prices of some drugs by more than 2,000%, a Sunday Times investigation has revealed.

The companies are avoiding the strict rules governing the prices of branded drugs in the NHS by “debranding” them and selling them as generic drugs. As a result the costs of some treatments for conditions ranging from high blood pressure to insomnia have spiralled.

The investigation has found:

•The price of Symmetrel, a treatment for Parkinson’s disease which was debranded in October 2014 and sold as amantadine, rose from £5.33 to £130.99 for a 150ml oral solution between November 2013 and October 2015 — an increase of 2,358%

•A packet of 250mg capsules of the epilepsy drug Mysoline, sold under the generic name primidone since October 2013, has risen from £12.60 to £93.75 — an increase of 644%.

Have you manage to get Jeremy Corbyn and/or John McDonnell on board? Surely this is the sort of red issue they would love to get their teeth into. Unless they have a conflict of interest; do you know if the Pharma employees are unionised?

This blog has become socialist and has moved too far to the left. Socialism (and communism for that matter) as a political system has not proven to be very effective at delivering innovative medicines. Big Pharma is simply capitalism's response to the failure of socialism to deliver. I suggest you try not to interfere with the market unless you have a watertight system to replace it. People with MS would be a lot worse off if it wasn't for Big Pharma stepping up to mark. Unfortunately, you can't have it both ways.

The issue has nothing to do with economic systems, but with the right price, reasonable price at which people can really afford it, to be charged in a drug and the reuse of many existing drugs, including for the treatment of other diseases, for the treatment of MS, such as the possible neuroprotective. This will not stop innovation, much less end with the profits made by Big Pharma ... the Blog has not become "socialist" by such an idea, expand more your mind ...

I really wish people would cut out the ill-informed references to William Wallace, or rather Mel Gibson. This film did a huge disservice to the UK in romanticising Scottish history. Read about the very much more boring and inspid facts of Scottish history before you start promoting its falsification and further entrenching the break up of the Union.

I was not referring to the kilts at all, but a much wider and more serious issue, as already summarised briefly in my comment above and below. Perhaps you should read them and then _think_. I suggest you stick to what you're good at, and yes, to debating repurposing.

I admit, I was excessively grumpy about this. But I stand by my opinions. We'll agree to disagree? Only because I respect the work that you do, and your MouseDoctor avatar is so cute. Not because I like your SNP/Wallace references in this post.

I actually find the references referring to the SNP as though they would represent the ideology of William Wallace really stupid and actually offensive, given the wave of nationalism spreading through my country and what it is doing to the UK. Why people hark so readily back to ancient history and forget how men and women of the UK died together and for each other in the World Wars I do not know. I suggest that you cut out this bull**** on this blog.

All this is far more complex than meets the eye's. Pharma makes profit, they are a business. Is this at times excessive. Surely. A Ferrari is also more than my Hyundai and it services a vertical market. A service center need be trained in ferrari's. None of these "systems" is easily navigated via a blog post. The Obama Care documents towards US national care will rival any encyclopedia in size.

The US pays more across the boards for health care and much of that money floats globally, just as the UK pays $6.50 (US) for a gallon of gas, we pay $2.20 (US). If the US had to bare burden of a balanced global fuel cost lets call it, we are all done. Economy go poof and world will follow.

Why is Pharma as one entity per se being rather encouraged in many ways to come to the US? Because the US is seeking global means of economics towards globalization having in past years lost most production to other nations. Even service industries to other nations.

Beyond all this, point being. All these matters are far more complex than a blog or any 50 blogs can matter of fact like reasonably discuss as we do not know all the facts. Trying single out industries does not work well when industries were global 40 years ago. Trying to do so now is far far more complex than back then.

A #LARGE# mistake is attempting listen to US Media, LA TImes, whatall. If Prof G whom I respect immensely as his compassion and humanity is on a scale seldom witnessed by highly educated professionals these days is going to take US News as a indicator of much anything... Well... We all make errors. US News media which was a founding fathers "Free press" foundation, a check and balance system, is no longer that. This is why its been said many place in the US that Al'Jazerra is now a more credible global news resource than CNN. Media corporation groups rape and pillage more than Pharma and in a variety of ways.

The UK checks and balances fight and they do so public facing. Here, used to be the same way. Not any more. The US used to be a global social lion albeit a directed and capitalistic one back in the days of "US vs Them" (which in many ways was a ruse).

You really have to live here to even attempt get any real grasp on how the US works and how perceptually it is said to work and the truth actually be someplace inbetween.

The press here is a money making goliath where-as it used to be primarily the mechanism of accountability to gov., business, social aspects and more. When is the last time anyone saw news media in the US calling for people to move towards large organized protests of anything?

The last time people globally (and here, US as well) was the "sit outs" where people were protesting global banking and such. People here were arrested in many places, even Central Park NY. Point being, media here is not what Prof. G might think it is given the USA's proud history of media. That's all changed. In fact, most people here dont even read the stuff. They get their news via TV, 1 minutes and 30 seconds on whatall, and they are experts. YET! If a hurricane hits people are glued to The Weather Channel for live TV. All very odd.

Pharma to me is not an enemy, they are businesses. They are charging large amounts of money for vertical market disease therapies. Should it be capped? Perhaps. States here in the US are looking at just that. They are complex businesses. Is there gouging? Sure. Acthar I read some years back was $1400 or thereabouts for 5 shots. I had to have Acthar earlier this year, saw the bill. $38,000 for 5 shots.

Ms Unites, I think you sell your countrymen short, and I would hazard to guess that you're older. Speaking as a fellow citizen of the U.S., I - and most of the people I know - don't believe most of the nonsense spewed over the television airwaves. Pretty much everyone 45 and under scour the Internet for data from a variety of sources precisely because we've given up on the (bought and paid for) regular U.S. media channels.

I would also add that comparing the excesses of big pharma to Ferraris is disingenuous. A consumer can opt into buying a Ferrari if they have the cash and choose to do so. A person with MS (or any other disease) has little choice in choosing to forego therapy. Doing so runs the very real, and probable risk of horrible disability later in life (and sometimes sooner).

Sure, Capitalism isn't necessarily bad. It's unbridled, unprincipled, utterly free-market Capitalism that's the true problem here. Greed has overstepped the public good. Regulation is desperately needed. Not Socialism, or Communism, but smartly regulated Capitalism. Mouse Doctor has it right. Change is desperately needed, and long overdue. In the U.K., and the U.S., as well as many other places around the world.

My MP replied to my email, "As many of the Westminster SNP Group as possible will aim to attend and vote in support of this Private Members Bill and we hope that the UK Government will then take it forward. ".

There is a good point to be made here. The movie Braveheart apparently erroneously displayed history. Funny, so did the history books when I was in school back in the 70's, 1970's, nearly a forever ago LOL.

Is it a surprise? No. Feature films are money and besides, truth of any individuals lifetime doesnt tend to fit into 2 hours of cinema unless they are 8 hours old.

Welcome to global media be it for entertainment or historical purposing or a bit of both.

The fact BARTS is on a form of hallowed ground is rather coolistic.

It is said that history is often written by the victors. Reality for anyone who has really studied history is its neither written by the victor or the looser but others interpretation and then a cascade of others who study what those others wrote.

Human beings are what they are. We have no other sentient race to compare ourselves with.

Not three weeks back I was at a dollar store getting balloons for a party. While waiting a person I'd not saw in years and I were talking about computers and technology.

I go to my fossil fuel powered Korean built gravity based mobility device with its round rubber machined ground contact points which some caveman designed that I may share DNA with. I place the balloons in my cargo section. A women comes up in back of me who apparently was standing in line at the dollar store hinged on the conversation I was having.

She says to me, "Your conversation about computers and technology was just fascinating to me. I think its incredible how much smarter computers are than people".

I pondered that for a moment, "What do I do?" Laugh? Cry? Ask her to breakdance on the pavement?

No kiddin'. Could NOT believe it.

So I said, "God bless you maam' " and I handed her a balloon that had written on it, "You win!".

Now if I did that to Professor G. I'd imagine he'd be insulted. I would be. This lady says, "Thank you so much" and trundles off to her fossil fueled locomotion device making me wonder again if we share the same DNA.

Don't the staff of Big Pharma, including the CEO's, pay tax? Does the government tax Big Pharma profits? Don't the shareholders of Big Pharma pay tax? Don't the pensioners' who draw on their pensions that have been invested in Big Pharma not pay tax?

I am not sure you comment that taxpayers pay twice is relevant. We have disease that needs to be treated it is all about partnerships. You portray Pharma as some sort of evil leech sucking blood out of society, when it is the opposite. Pharma are the part of the life blood. If I am not mistaken don't you guys' have shares in Pharma? If you don't believe in Pharma why don't you donate your shares to the MS Society?

Do they pay tax i(f they are not offshore:-)...yes but what is your point?.If they take charge less they would still pay tax and pensions would still be drawn. This is self serving so I can do what I like because you don't know how good it is for you. If it wasn't there Society would survive just as it did two hundred years ago it would just be different. However it is better for Health that pharma is there.

This has little to do with the debate on repurposing drugs.

You say they are an evil leech...I didn't say this at all. I didn't say the quotes you are accusing me of saying you have to read the article..Pharma is a business that is needed for the health of society we have said this very often that academics do not make drugs.

You say It's all about Partnerships.....This sounds like some marketing speak. I make drugs, you buy them? So if I say you are a cartel and your drugs cost too much so that they are unaffordable to all, would a partner listen and act?

Do we have shares in Pharma, not exactly, my shares come from a virutal company I set up, which reminds me to try an find the certificate.:-)

"Rather than making patient, long-term investments, large shareholders in Big Pharma companies are looking for a quick, easy, guaranteed return."

I think Pharma would be most keen on having a re-purposing scheme instead of spending money tweaking immunosuppressive drugs. This would same them a lot of money by just picking the next immunosuppressant off the shelf without modification.

Investing in research to find a cure such as a way to restore self tolerance seems to expensive, so why wouldn't Pharma support the repurposing scheme?

PML Risk Infographic

Search this Blog

Follow by Email

Subscribe To

Translate

Disclaimer

General Disclaimer: Please note that the opinions expressed here are those of the individual bloggers and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry, Queen Mary University of London or Barts Health NHS Trust.

Survey Disclaimer: No personal identifiers will be collected as part of these surveys. By completing these surveys you are consenting to the data you provide being analysed by Professors Giovannoni and Baker and their collaborators. Results of these surveys will be presented on this blog and may be submitted for publication.